TRI STATE OCULAR PROSTHETICS, LLC (NPI# 1205974516) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205974516 |
| Entity Type | Organization |
| Organization Name | TRI STATE OCULAR PROSTHETICS, LLC |
| Practice Address |
130 Tri County Pkwy Suite 201 Cincinnati OH 45246-3289 |
| Practice Telephone | 5137716029 |
| Practice Fax Number | 5137716187 |
| Mailing Telephone | 5137716029 |
| Mailing Fax Number | 5137716187 |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2016-07-11 |
| Authorized Official Name | ANDREW W HETZLER (PRESIDENT) |
| Authorized Official Telephone | 5133102060 |
| Authorized Official Credential | B.C.O., B.A.D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 156FX1700X |
Technician/Technologist Specialization: Ocularist |
O.11 | OH | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0063218 | 05 | |
| OH | ANTHEM | 511527 | 01 |
| KY | 7100005950 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | TRI STATE OCULAR PROSTHETICS, LLC | 130 Tri County Pkwy Ste 201, Cincinnati, OH 45246-3235 |
| Street Address |
130 TRI COUNTY PKWY SUITE 201 |
| City | CINCINNATI |
| State | OH |
| Zip Code | 45246-3289 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568467074 | Hetzler Ocular Prosthetic, Inc | Prosthetic/Orthotic Supplier | 130 Tri County Pkwy, Ste 201, Cincinnati, OH 45246-3235 | 2005-06-21 |
| 1164896031 | Millenium Nursing Care LLC | Nursing Care | 130 Tri County Pkwy, Ste 215, Cincinnati, OH 45246-3289 | 2015-11-16 |
| 1952784118 | Goldbuck Usa, LLC | Durable Medical Equipment & Medical Supplies | 130 Tri County Pkwy, Suite 215, Cincinnati, OH 45246-3289 | 2015-07-07 |
| 1124376439 | Millenium Nursing Agency | Home Health | 130 Tri County Pkwy, Cincinnati, OH 45246-3289 | 2012-08-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033766241 | Stephanie Ann Hayes | Counselor | 42 East Crescentville Drive, Cincinnati, OH 45246 | 2019-08-22 |
| 1689228132 | Jessica D Mandich | Social Worker | 415 Glensprings Drive Suite 201, Cincinnati, OH 45246 | 2019-08-01 |
| 1649832338 | Combine Home Care | Home Health | 260 Northland Blvd Ste 234, Cincinnati, OH 45246 | 2019-07-02 |
| 1215593488 | Premier Care of Ohio, LLC. | Clinic/Center | 42 E Crescentville Road, Cincinnati, OH 45246 | 2019-05-14 |
| 1295205276 | Emmanuel Bio Antwi | Adult Companion | 230 Northland Blvd Suite 112, Cincinnati, OH 45246 | 2018-12-03 |
| 1225567506 | Rebecca J Travis | Case Manager/Care Coordinator | 11590 Century Blvd Suite 116, Cincinnati, OH 45246 | 2017-06-08 |
| 1245770320 | Tiffany Burton | Behavior Technician | 11789 Rose Lane, Cincinnati, OH 45246 | 2017-03-08 |
| 1306207964 | Adriana Harris | Home Health Aide | 270 Northland Blvd Ste 112, Springdale, OH 45246 | 2016-03-10 |
| 1891124251 | Leslie Ann Cooper | Social Worker | 316 Cleveland Avenue, Cincinnati, OH 45246 | 2013-11-06 |
| 1144564071 | Premier Care of Ohio, Inc. | Community/Behavioral Health | 42 E. Crescentville Road, West Chester, OH 45246 | 2012-11-15 |
| Find all providers in zip 45246 | ||||
| Taxonomy Code | 156FX1700X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Ocularist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679047609 | Melissa Frederick | Technician/Technologist | 1422 Euclid Ave Ste 802, Cleveland, OH 44115-2001 | 2019-01-12 |
| 1568936680 | Darrell W Hardin | Technician/Technologist | 34950 Chardon Rd Ste 103, Willoughby Hills, OH 44094-9162 | 2019-01-11 |
| 1609014315 | Miller Artificial Eye Laboratory, Inc. | Technician/Technologist | 3030 W. Sylvania Avenue, Suite 13, Toledo, OH 43613-4147 | 2009-02-03 |
| 1629129432 | Theodore R Arlotto | Technician/Technologist | 6315 Pearl Rd Ste 301b, Parma Heights, OH 44130-3074 | 2007-01-16 |
| 1669495040 | Miller Artificial Eye Laboratory, Inc. | Technician/Technologist | 3425 Executive Pkwy Ste 108, Toledo, OH 43606-1333 | 2006-07-26 |
| City | CINCINNATI |
| Zip Code | 45246 |
Please comment or provide details below to improve the information on TRI STATE OCULAR PROSTHETICS, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.